Individual
MRS. KATELYN DEADERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-1765
Mailing address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
RN9581797
FL
363LF0000X
Family Nurse Practitioner
Primary
APRN11024131
FL
Other
Enumeration date
09/23/2022
Last updated
12/17/2025
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